NIPAL4 codes for a magnesium transporter that can also transport other divalent cations such as Ba2+, Mn2+, Sr2+ and Co2+, though to a much less extent than Mg2+.[5] There is also evidence that NIPAL4 is involved in the synthesis of very long chain fatty acids involved in the epidermal lipid metabolism.[7] Disruptions to this pathway results in impaired skin function, causing the symptoms of ARCI.[8]
Mutations in this gene account for 16% of autosomal recessive congenital ichthyosis (ARCI) cases, making it the 2nd most common gene involved with this disease.[9] Since its first identification in 2004, 18 disease‐causing mutations have been reported in NIPAL4.[8]